Open Access

ARTICLE

Outcomes of a urethroplasty algorithm for fossa navicularis strictures

Mark Broadwin¹, Alex J. Vanni²

1 Tufts University School of Medicine, Boston, Massachusetts, USA
2 Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
Address correspondence to Dr. Alex J. Vanni, Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805 USA

Canadian Journal of Urology 2018, 25(6), 9591-9595.

Abstract

Introduction: There is no standardized treatment algorithm for isolated fossa navicularis strictures and treatment modality often falls to surgeon preference. We evaluated the outcomes of a standardized algorithm for fossa navicularis strictures based on stricture etiology, lumen size, and glans size to minimize the number of patients requiring a two-stage urethral reconstruction.
Materials and methods: We retrospectively reviewed a prospectively maintained urethral reconstruction database by a single surgeon from 2011-2018. A treatment algorithm was applied and patients underwent one of three treatment modalities: a two-stage buccal mucosa graft (BMG), a single-stage dorsal inlay BMG, or a single-stage dorsal inlay BMG and ventral fasciocutaneous flap repair. Stricture recurrence was measured by inability to pass a 17 Fr flexible cystoscope. Patient sexual function and satisfaction were evaluated by the International Index of Erectile Function (IIEF) and a patient perception questionnaire.
Results: Forty-two patients met inclusion criteria with a mean follow up of 12.3 months. Urethroplasty success rate was 92%. There was no change in IIEF scores pre and postoperatively between single stage BMG, two-stage BMG, and combined BMG and flap repairs (+0.4; p = 0.88, 0.0; p = 1.00, and -0.3; p = 0.74). Ninety-four percent of patients reported being very satisfied or satisfied with their reconstruction.
Conclusion: An algorithmic approach to the treatment of fossa navicularis strictures is an appropriate method for reconstructive intervention with a high rate of success and patient satisfaction with no significant impact on erectile function.

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